<div class="login">
  <div class="login-screen">
    <div class="login-icon">
      <img src="@routes.Assets.versioned("images/icons/svg/chat.svg")" alt="Welcome to Mail App">
      <h4>歡迎加入<small>vips</small></h4>
    </div>

    <div class="login-form">
      <div class="form-group">
        <input type="text" class="form-control login-field" value="" placeholder="姓名" id="login-name">
        <label class="login-field-icon fui-user" for="login-name"></label>
      </div>
      <div class="form-group">
        <input type="password" class="form-control login-field" value="" placeholder="密碼" id="login-pass">
        <label class="login-field-icon fui-lock" for="login-pass"></label>
      </div>
			
			<div class="form-group">
				<input type="text" class="form-control login-field" value="" placeholder="地址" id="login-addr">
        <label class="login-field-icon fui-home" for="login-addr"></label>
			</div>
			
			<div class="form-group">
				<input type="text" class="form-control login-field" value="" placeholder="電話號碼" id="login-phone">
        <label class="login-field-icon fui-apple" for="login-phone"></label>
			</div>

			<div class="form-group">
				<span class="bootstrap-switch-square">
            <div class="bootstrap-switch bootstrap-switch-wrapper bootstrap-switch-id-custom-switch-04 bootstrap-switch-animate bootstrap-switch-on"><div class="bootstrap-switch-container"><span class="bootstrap-switch-handle-on bootstrap-switch-primary">VIP</span><label class="bootstrap-switch-label">&nbsp;</label><span class="bootstrap-switch-handle-off bootstrap-switch-default">OFF</span><input type="checkbox" checked="" data-toggle="switch" data-on-label="<i class='fui-check'></i>" data-off-label="<i class='fui-cross'></i>" name="switch-04" id="custom-switch-04"></div></div>
          </span>
			</div>
      <a class="btn btn-primary btn-lg btn-block" id="addCustomer" href="#">註冊</a>
    </div>
  </div>
</div>